Organization
OCEAN PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JITENDRA C PATEL MD (MEDICAL DIRECTOR)
(541) 469-6817
Entity
Organization
Contact information
Practice address
984 PARKVIEW DR, BROOKINGS, OR 97415-9116
(541) 469-6817
Mailing address
PO BOX 6988, BROOKINGS, OR 97415-0355
(541) 469-6817
(541) 469-3768
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
1062291-7
OR
311500000X
Alzheimer Center (Dementia Center)
Primary
1062291-7
OR
Other
Enumeration date
05/28/2008
Last updated
05/28/2008
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